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Spitzer D, Guérit S, Puetz T, Khel MI, Armbrust M, Dunst M, Macas J, Zinke J, Devraj G, Jia X, Croll F, Sommer K, Filipski K, Freiman TM, Looso M, Günther S, Di Tacchio M, Plate KH, Reiss Y, Liebner S, Harter PN, Devraj K. Profiling the neurovascular unit unveils detrimental effects of osteopontin on the blood-brain barrier in acute ischemic stroke. Acta Neuropathol 2022; 144:305-337. [PMID: 35752654 PMCID: PMC9288377 DOI: 10.1007/s00401-022-02452-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/01/2022]
Abstract
Blood-brain barrier (BBB) dysfunction, characterized by degradation of BBB junctional proteins and increased permeability, is a crucial pathophysiological feature of acute ischemic stroke. Dysregulation of multiple neurovascular unit (NVU) cell types is involved in BBB breakdown in ischemic stroke that may be further aggravated by reperfusion therapy. Therefore, therapeutic co-targeting of dysregulated NVU cell types in acute ischemic stroke constitutes a promising strategy to preserve BBB function and improve clinical outcome. However, methods for simultaneous isolation of multiple NVU cell types from the same diseased central nervous system (CNS) tissue, crucial for the identification of therapeutic targets in dysregulated NVU cells, are lacking. Here, we present the EPAM-ia method, that facilitates simultaneous isolation and analysis of the major NVU cell types (endothelial cells, pericytes, astrocytes and microglia) for the identification of therapeutic targets in dysregulated NVU cells to improve the BBB function. Applying this method, we obtained a high yield of pure NVU cells from murine ischemic brain tissue, and generated a valuable NVU transcriptome database ( https://bioinformatics.mpi-bn.mpg.de/SGD_Stroke ). Dissection of the NVU transcriptome revealed Spp1, encoding for osteopontin, to be highly upregulated in all NVU cells 24 h after ischemic stroke. Upregulation of osteopontin was confirmed in stroke patients by immunostaining, which was comparable with that in mice. Therapeutic targeting by subcutaneous injection of an anti-osteopontin antibody post-ischemic stroke in mice resulted in neutralization of osteopontin expression in the NVU cell types investigated. Apart from attenuated glial activation, osteopontin neutralization was associated with BBB preservation along with decreased brain edema and reduced risk for hemorrhagic transformation, resulting in improved neurological outcome and survival. This was supported by BBB-impairing effects of osteopontin in vitro. The clinical significance of these findings is that anti-osteopontin antibody therapy might augment current approved reperfusion therapies in acute ischemic stroke by minimizing deleterious effects of ischemia-induced BBB disruption.
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Affiliation(s)
- Daniel Spitzer
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,Department of Neurology, University Hospital, Goethe University, 60528 Frankfurt, Germany ,grid.7839.50000 0004 1936 9721LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528 Frankfurt, Germany
| | - Sylvaine Guérit
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Tim Puetz
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,Department of Neurology, University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Maryam I. Khel
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Moritz Armbrust
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Maika Dunst
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Jadranka Macas
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Jenny Zinke
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Gayatri Devraj
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Xiaoxiong Jia
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Florian Croll
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Kathleen Sommer
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Katharina Filipski
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK) Partner site Frankfurt/Mainz, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany ,grid.511198.5Frankfurt Cancer Institute (FCI), 60528 Frankfurt, Germany
| | - Thomas M. Freiman
- grid.413108.f0000 0000 9737 0454Department of Neurosurgery, University Medical Center Rostock, 18057 Rostock, Germany ,grid.7839.50000 0004 1936 9721LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528 Frankfurt, Germany
| | - Mario Looso
- grid.418032.c0000 0004 0491 220XMax Planck Institute for Heart and Lung Research, 61231 Bad Nauheim, Germany
| | - Stefan Günther
- grid.418032.c0000 0004 0491 220XMax Planck Institute for Heart and Lung Research, 61231 Bad Nauheim, Germany
| | - Mariangela Di Tacchio
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany
| | - Karl-Heinz Plate
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK) Partner site Frankfurt/Mainz, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany ,grid.511198.5Frankfurt Cancer Institute (FCI), 60528 Frankfurt, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), Partner Site Frankfurt/Mainz, 60528 Frankfurt, Germany ,grid.7839.50000 0004 1936 9721LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528 Frankfurt, Germany
| | - Yvonne Reiss
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK) Partner site Frankfurt/Mainz, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany ,grid.511198.5Frankfurt Cancer Institute (FCI), 60528 Frankfurt, Germany ,grid.7839.50000 0004 1936 9721LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528 Frankfurt, Germany
| | - Stefan Liebner
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Research (DZHK), Partner Site Frankfurt/Mainz, 60528 Frankfurt, Germany ,Excellence Cluster Cardio Pulmonary System (CPI), Partner Site Frankfurt, 60528 Frankfurt, Germany ,grid.7839.50000 0004 1936 9721LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528 Frankfurt, Germany
| | - Patrick N. Harter
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK) Partner site Frankfurt/Mainz, 60528 Frankfurt, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany ,grid.511198.5Frankfurt Cancer Institute (FCI), 60528 Frankfurt, Germany ,grid.7839.50000 0004 1936 9721LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528 Frankfurt, Germany
| | - Kavi Devraj
- Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528, Frankfurt, Germany. .,Frankfurt Cancer Institute (FCI), 60528, Frankfurt, Germany. .,LOEWE - Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, 60528, Frankfurt, Germany.
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Devraj G, Guérit S, Seele J, Spitzer D, Macas J, Khel MI, Heidemann R, Braczynski AK, Ballhorn W, Günther S, Ogunshola OO, Mittelbronn M, Ködel U, Monoranu CM, Plate KH, Hammerschmidt S, Nau R, Devraj K, Kempf VAJ. HIF-1α is involved in blood-brain barrier dysfunction and paracellular migration of bacteria in pneumococcal meningitis. Acta Neuropathol 2020; 140:183-208. [PMID: 32529267 PMCID: PMC7360668 DOI: 10.1007/s00401-020-02174-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
Bacterial meningitis is a deadly disease most commonly caused by Streptococcus pneumoniae, leading to severe neurological sequelae including cerebral edema, seizures, stroke, and mortality when untreated. Meningitis is initiated by the transfer of S. pneumoniae from blood to the brain across the blood-cerebrospinal fluid barrier or the blood-brain barrier (BBB). The underlying mechanisms are still poorly understood. Current treatment strategies include adjuvant dexamethasone for inflammation and cerebral edema, followed by antibiotics. The success of dexamethasone is however inconclusive, necessitating new therapies for controlling edema, the primary reason for neurological complications. Since we have previously shown a general activation of hypoxia inducible factor (HIF-1α) in bacterial infections, we hypothesized that HIF-1α, via induction of vascular endothelial growth factor (VEGF) is involved in transmigration of pathogens across the BBB. In human, murine meningitis brain samples, HIF-1α activation was observed by immunohistochemistry. S. pneumoniae infection in brain endothelial cells (EC) resulted in in vitro upregulation of HIF-1α/VEGF (Western blotting/qRT-PCR) associated with increased paracellular permeability (fluorometry, impedance measurements). This was supported by bacterial localization at cell-cell junctions in vitro and in vivo in brain ECs from mouse and humans (confocal, super-resolution, electron microscopy, live-cell imaging). Hematogenously infected mice showed increased permeability, S. pneumoniae deposition in the brain, along with upregulation of genes in the HIF-1α/VEGF pathway (RNA sequencing of brain microvessels). Inhibition of HIF-1α with echinomycin, siRNA in bEnd5 cells or using primary brain ECs from HIF-1α knock-out mice revealed reduced endothelial permeability and transmigration of S. pneumoniae. Therapeutic rescue using the HIF-1α inhibitor echinomycin resulted in increased survival and improvement of BBB function in S. pneumoniae-infected mice. We thus demonstrate paracellular migration of bacteria across BBB and a critical role for HIF-1α/VEGF therein and hence propose targeting this pathway to prevent BBB dysfunction and ensuing brain damage in infections.
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Affiliation(s)
- Gayatri Devraj
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
| | - Sylvaine Guérit
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Jana Seele
- Institute of Neuropathology, University Medical Center, Göttingen, Germany ,Department of Geriatrics, Evangelisches Krankenhaus, Göttingen-Weende, Germany
| | - Daniel Spitzer
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Jadranka Macas
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Maryam I. Khel
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Roxana Heidemann
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Anne K. Braczynski
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Department of Neurology, Technische Hochschule University Hospital, Aachen, Germany
| | - Wibke Ballhorn
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
| | - Stefan Günther
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | | | - Michel Mittelbronn
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg ,Laboratoire National de Santé (LNS), Dudelange, Luxembourg ,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg, Luxembourg ,NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
| | - Uwe Ködel
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany
| | - Camelia M. Monoranu
- Department of Neuropathology, Institute of Pathology, Julius Maximilians University, Würzburg, Germany
| | - Karl H. Plate
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Roland Nau
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Kavi Devraj
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany. .,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
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Nguyen NTT, Röttgerding F, Devraj G, Lin YP, Koenigs A, Kraiczy P. The Complement Binding and Inhibitory Protein CbiA of Borrelia miyamotoi Degrades Extracellular Matrix Components by Interacting with Plasmin(ogen). Front Cell Infect Microbiol 2018; 8:23. [PMID: 29456970 PMCID: PMC5801413 DOI: 10.3389/fcimb.2018.00023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/17/2018] [Indexed: 12/26/2022] Open
Abstract
The emerging relapsing fever spirochete Borrelia (B.) miyamotoi is transmitted by ixodid ticks and causes the so-called hard tick-borne relapsing fever or B. miyamotoi disease (BMD). More recently, we identified a surface-exposed molecule, CbiA exhibiting complement binding and inhibitory capacity and rendering spirochetes resistant to complement-mediated lysis. To gain deeper insight into the molecular principles of B. miyamotoi-host interaction, we examined CbiA as a plasmin(ogen) receptor that enables B. miyamotoi to interact with the serine protease plasmin(ogen). Recombinant CbiA was able to bind plasminogen in a dose-dependent fashion. Moreover, lysine residues appear to play a crucial role in the protein-protein interaction as binding of plasminogen was inhibited by the lysine analog tranexamic acid as well as increasing ionic strength. Of relevance, plasminogen bound to CbiA can be converted by urokinase-type plasminogen activator (uPa) to active plasmin which cleaved both, the chromogenic substrate S-2251 and its physiologic substrate fibrinogen. Concerning the involvement of specific amino acids in the interaction with plasminogen, lysine residues located at the C-terminus are frequently involved in the binding as reported for various other plasminogen-interacting proteins of Lyme disease spirochetes. Lysine residues located within the C-terminal domain were substituted with alanine to generate single, double, triple, and quadruple point mutants. However, binding of plasminogen to the mutated CbiA proteins was not affected, suggesting that lysine residues distant from the C-terminus might be involved in the interaction.
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Affiliation(s)
- Ngoc T T Nguyen
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Frankfurt, Germany
| | - Florian Röttgerding
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Frankfurt, Germany
| | - Gayatri Devraj
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Frankfurt, Germany
| | - Yi-Pin Lin
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - Arno Koenigs
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Frankfurt, Germany.,VIROTECH Diagnostics GmbH, Rüsselsheim, Germany
| | - Peter Kraiczy
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Frankfurt, Germany
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Devraj G, Beerlage C, Brüne B, Kempf VAJ. Hypoxia and HIF-1 activation in bacterial infections. Microbes Infect 2016; 19:144-156. [PMID: 27903434 DOI: 10.1016/j.micinf.2016.11.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/14/2016] [Accepted: 11/21/2016] [Indexed: 12/22/2022]
Abstract
For most of the living beings, oxygen is one of the essential elements required to sustain life. Deprivation of oxygen causes tissue hypoxia and this severely affects host cell and organ functions. Tissue hypoxia is a prominent microenvironmental condition occurring in infections and there is a body of evidence that hypoxia and inflammation are interconnected with each other. The primary key factor mediating the mammalian hypoxic response is hypoxia inducible factor (HIF)-1, which regulates oxygen homeostasis on cellular, tissue and organism level. Recent studies show that HIF-1 plays a central role in angiogenesis, cancer and cardiovascular disease but also in bacterial infections. Activation of HIF-1 depends on the nature of the pathogen and the characteristics of infections in certain hosts. Up to date, it is not completely clear whether the phenomenon of HIF-1 activation in infections has a protective or detrimental effect on the host. In this review, we give an overview of whether and how hypoxia and HIF-1 affect the course of infections.
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Affiliation(s)
- Gayatri Devraj
- Institute of Medical Microbiology and Infection Control, Goethe-University, Paul-Ehrlich-Str. 40, D-60596 Frankfurt am Main, Germany
| | - Christiane Beerlage
- Institute of Medical Microbiology and Infection Control, Goethe-University, Paul-Ehrlich-Str. 40, D-60596 Frankfurt am Main, Germany
| | - Bernhard Brüne
- Institute of Biochemistry I - Pathobiochemistry, Goethe-University, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany
| | - Volkhard A J Kempf
- Institute of Medical Microbiology and Infection Control, Goethe-University, Paul-Ehrlich-Str. 40, D-60596 Frankfurt am Main, Germany.
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